Nokea
Which of the following diseases is not caused by enteroviruses?
- A. Myocarditis
- B. Infectious mononucleosis
- C. Herpangina
- D. Boston Exanthema
Correct Answer: B
Rationale: Answer B, Infectious mononucleosis, is not caused by enteroviruses. Infectious mononucleosis is primarily caused by the Epstein-Barr virus, a member of the herpesvirus family, not by enteroviruses. Enteroviruses are known to cause diseases such as myocarditis, herpangina, and Boston exanthema. Therefore, B is the correct answer. Myocarditis, herpangina, and Boston exanthema can all be caused by enteroviruses, making choices A, C, and D incorrect, respectively.
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A 37-year-old male was admitted to a hospital complaining of abdominal pain, difficulty in swallowing and breathing, constipation, and nausea. He developed respiratory failure and required endotracheal intubation and ventilation. Two days before, the patient consumed dried salted fish bought from an artisanal producer. Laboratory investigation for infectious pathogen was performed using Kitt-Tarozzi's method. Observation under a bright field microscopy revealed the presence of typical microorganisms with tennis racket appearance. Which of the following is the most likely diagnosis?
- A. Botulism
- B. Cholera
- C. Nontyphoidal Salmonella infection
- D. Typhoid fever
Correct Answer: A
Rationale: The correct answer is A: Botulism. Botulism is caused by the toxin produced by Clostridium botulinum bacteria found in improperly preserved or canned foods. The symptoms described align with botulism, such as difficulty swallowing and breathing due to muscle paralysis. The tennis racket appearance seen under microscopy corresponds to the characteristic appearance of Clostridium botulinum spores. The other choices can be ruled out based on the clinical presentation and microscopy findings. Cholera typically presents with severe watery diarrhea, Nontyphoidal Salmonella infection with fever and gastrointestinal symptoms, and Typhoid fever with high fever and abdominal pain. Therefore, the most likely diagnosis in this case is botulism.
A 45-year-old patient complains of body temperature rise up to 40oC, general weakness, headache, painfulness and spastic muscle contractions around the wound in the shin. He received this wound 5 days ago when working in his garden. He requested no medical care back then. What wound infection can be suspected?
- A. Tetanus
- B. Anthrax
- C. Erysipelas
- D. Gram-positive
Correct Answer: A
Rationale: The correct answer is A: Tetanus. The patient's symptoms of muscle contractions, fever, and wound history suggest tetanus, caused by Clostridium tetani bacteria commonly found in soil. The spastic muscle contractions around the wound are classic for tetanus due to the neurotoxin produced by the bacteria. General weakness and headache are also common symptoms.
B: Anthrax is unlikely as it presents with different symptoms such as skin lesions, respiratory symptoms, and gastrointestinal symptoms.
C: Erysipelas is characterized by red, swollen patches on the skin, not consistent with the symptoms described.
D: Gram-positive is not a specific diagnosis but a broad category of bacteria. Tetanus is caused by Clostridium tetani, which is a Gram-positive bacterium, but this choice does not provide a specific infection diagnosis.
While registering the child to the school Mantoux's test was made to define whether revaccination was needed test result is negative. What does this result of the test mean?
- A. Absence of antitoxic immunity to the tuberculosis
- B. Presence of antibodies for tubercle bacillus
- C. Absence of antibodies for tubercle bacillus
- D. Presence of cell immunity to the tuberculosis
Correct Answer: D
Rationale: Step 1: Mantoux test measures cell-mediated immunity response to tuberculosis.
Step 2: A negative result means no significant immune response to TB antigens.
Step 3: Option A is incorrect, as it refers to antitoxic immunity, not cell immunity.
Step 4: Option B is incorrect, as it mentions antibodies, not cell-mediated immunity.
Step 5: Option C is incorrect, as it states absence of antibodies, not cell immunity.
Step 6: Option D is correct as it directly correlates with the purpose of Mantoux test.
Crude herbal drugs must be examined for yeast-like fungi. What agar can ensure development of these microorganisms so that associating microflora will grow very slowly or won't grow at all?
- A. Sabouraud's peptone agar
- B. Endo agar
- C. Milk-salt agar
- D. Meat infusion agar
Correct Answer: A
Rationale: The correct answer is A: Sabouraud's peptone agar. This agar is specifically designed for the isolation of yeast and molds due to its low pH and high sugar content, creating an environment conducive for their growth. Yeast-like fungi thrive in this selective medium, while inhibiting the growth of bacteria and other contaminants.
Summary:
- Sabouraud's peptone agar is ideal for cultivating yeast-like fungi.
- Endo agar is used for isolation of gram-negative bacteria, not fungi.
- Milk-salt agar is used for lactobacilli and streptococci, not fungi.
- Meat infusion agar is a general-purpose medium for cultivation of a wide range of microorganisms, not specifically for yeast-like fungi.
Systemic amebiasis with involvment of intestines, liver, lungs was diagnosed in a 52-year-old patient. What drug should be prescribed?
- A. Quiniofone
- B. Enteroseptol
- C. Metronidazole
- D. Tetracycline
Correct Answer: C
Rationale: Rationale: Metronidazole is the drug of choice for systemic amebiasis due to its high efficacy against Entamoeba histolytica. It has good tissue penetration and can treat intestinal, liver, and lung involvement. Quiniofone (A) has limited use and is not recommended for amebiasis. Enteroseptol (B) is not effective against systemic amebiasis. Tetracycline (D) is not the first-line treatment for amebiasis and has limited efficacy against Entamoeba histolytica.